Nose bleeds

Question 1

How should you manage a patient with a nose bleed?

Answer 1

-Sit with their upper body tilted forward and their mouth open. Avoid lying down unless feeling faint. Leaning forward decreases blood flow through the nasopharynx, allows spitting out of blood, and minimises swallowing blood that drains into the pharynx.

-Pinch the cartilaginous (soft) part of the nose firmly and hold it for 10–15 minutes without releasing the pressure, whilst breathing through their mouth.

Question 2

What to do if bleeding does not stop within 10-15minutes of applying pressure?

Answer 2

If bleeding does not stop after 10–15 minutes of nasal pressure and the appropriate expertise and facilities are available in primary care, consider:

–> Nasal cautery: if the bleeding point can be seen and the procedure can be tolerated (for example in adults and older children, but not younger children).

–>Nasal packing: if nasal cautery is ineffective or the bleeding point cannot be seen. Admit the person to hospital if a nasal pack has been inserted in primary care.